“You don’t really care if I live or die. Why don’t I just kill myself–then everyone will be happy.”

“If you loved me, you would do what I tell you.”

If you are on the receiving end of threats like these, whether they come from your partner, your parent, your sibling, your child, or your friend, it can feel like a bucket of ice water has been poured over your head.

Mental illnesses come with the risk of suicide. Some diagnoses, such as borderline personality disorder, come with a 10% suicide completion rate, although there are often many attempts that are unsuccessful or are simply an exaggerated cry for help. Other disorders, including depression, eating disorders, and substance abuse, carry suicide risks as well.

If the person in your life truly wants to die and/or has a suicide plan and a means to carry out that plan, you need immediate assistance. Call 911 or your local emergency number for assistance. Alternatively, you can call the National Suicide Prevention Helpline at 1-800-273-TALK (8255).

Always take threats seriously and follow through with calling for help.

But what if you are constantly on the receiving end of threats like the ones above? Feelings of wanting to help soon turn to anger and resentment. Being constantly bombarded by comments from another person threatening to kill themselves is emotional blackmail. You never know what will come next, and as a result, feelings of anger, resentment, and fear all build up. It may feel like you have no choice but to do exactly what the person says in order to avoid a tragedy, but there are steps you can take to protect yourself and potentially save the other person’s life as well.

What to do when someone is threatening suicide as manipulation

Express concern for the person, but maintain your boundaries. Threatening suicide is very manipulative, and the other person is expecting you to yield to his demands. By saying, “I can tell you are really upset right now, and I want to help, but I will not [fill in the blank],” you are showing that you care, but are also not giving in.

Put the responsibility for living or dying back in the hands of the person who is threatening you. Say to the other person, “I don’t want you to have a relationship with me just because I am afraid of you dying and you think you can’t live without me. Our relationship should be based on mutual love and respect, not threats. I love you, but I can’t stop you from making this choice, even though I wish I could.”

Don’t argue with the other person about whether he is serious about dying. Assume all threats are serious, and act accordingly. If you argue the point, he may make an attempt just to prove you wrong.

Remember that contrary to what the other person is saying, you don’t have to prove anything. He may be saying, “If you loved me, you’d stop me from killing myself,” but the truth is, unless the core issues of what brought him to this place of wanting to end his life are addressed, giving in to his demands over and over again will not fix anything. You will still be angry, and the other person will still be vulnerable to wanting to self-harm again. The cycle will not break unless a trained professional steps in.

The above points are anything but easy to execute, so I strongly encourage anyone who is in a relationship with a chronically suicidal person get professional mental health services to learn how to handle such stress. It can feel very isolating, but you are not alone.

Kate Thieda, MS, LPCA, NCC, is a patient advocate for Women's and Children's Services at Duke University Hospital in Durham, North Carolina. She is a licensed professional counselor associate and a National Certified Counselor who specializes in cognitive-behavioral and dialectical behavior therapies. Her book, Loving Someone With Anxiety, will be published by New Harbinger in the spring of 2013.

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